Today, the disease of osteoarthritis of the joints has become the most common among all pathologies of the musculoskeletal system. In addition, urban dwellers, people who are accustomed to leading a sedentary life, and those who have recently suffered injuries of varying intensity, suffer from joint disorders more frequently.
The predictions of doctors in this regard are disappointing. It is assumed that, in the near future, the number of people suffering from various forms of osteoarthritis of large joints will only increase. According to the latest data, about 7 percent have experienced all the symptoms and consequences of osteoarthritis.
This disease has become one of the main causes of disability and decreased performance. It is characteristic that the peak of incidence occurs in the age groups of 40 to 60 years, and not only in elderly retirees, as is erroneously believed.
What is osteoarthritis?
Osteoarthritis (another name for osteoarthritis) should be understood as a complex degenerative pathology in which the cartilaginous plate of the bone that forms the joint is destroyed. The reasons do not lie only in the processes that occur in the hyaline cartilage.
There are many other prerequisites for the disease.
Arthrosis of the joints develops under the condition:
- excessive physical activityUsually overweight people get sick in such cases. Human joints are not designed for constant movement under heavy load. For this reason, the increased compression experienced by the knees during activity becomes a prerequisite for microtrauma to cartilage tissue. There is a violation of the sliding properties of tissues and a decrease in joint mobility. Athletes often suffer systematic joint damage due to frequent and sudden changes in natural pressure between joint surfaces or high loads with insufficiently heated joints;
- congenital or acquired deformities, injuries of the musculoskeletal system. In such conditions, the disease is provoked by improper contact of the articular surfaces of the bone. Absolutely all the load cannot be distributed over the joint and lesions are formed in places of excessive compression. A striking example of such a violation will be rickets, scoliosis, and kyphosis. It should also include improper fusion of broken bones, various limb deformities;
- violation of cartilage regeneration. This mechanism of development of osteoarthritis is observed in the presence of an inflammatory process in the body, impaired blood circulation and hormonal disturbances. The problem is based on the inadequate restoration of the lost cartilage tissue, the lack of natural remodeling and thinning;
- problems of formation and production of synovial fluid. In case of insufficient joint fluid, friction surfaces are constantly injured, their wear and inflammation accelerates, the general condition of the body worsens.
Stages of osteoarthritis
Since the osteoarthritis disease causes the destruction of the cartilaginous tissue of the joint, its symptoms vary significantly depending on the stage of the pathological process.
As a result of the active destruction of the joint surface, a person will experience new symptoms, and the prognosis for the restoration of motor activity will not change. Based on the clinical picture of the disease, the doctor will choose the optimal method of treatment and drugs.
Osteoarthritis of the first degree is characterized by the fact that discomfort and slight pain are felt only after prolonged intense exertion. After a short rest, the signs that have arisen during physical activity fade away.
In this case, joint injuries will not be visible on the X-ray photo, but a slight narrowing of the joint space is possible.
Stage 2 of the pathology is characterized by increased symptoms. Now there are pains not only as a result of prolonged activity, but also with minor movements of the limbs.
Rest will not bring the desired relief. There is stiffness in the movements, the mobility of the joint is limited. It is recommended at this time to reduce the load on the affected joints, but it should not be completely excluded, otherwise muscle atrophy occurs. An X-ray will show clear signs of osteoarthritis:
- bone growth;
- neoplasms (osteophytes) near the joint space, its narrowing.
When the disease reaches its final stage, joint injuries cause excruciating and constant pain. Therefore, at the level of reflexes, a person begins to drastically limit their movements to protect the affected joint from stress. Pain syndrome occurs even during sleep and rest, when the joints are at rest.
The patient is forced to adopt the position in which it hurts the least. Movement is only possible with the help of a wheelchair or crutches.
Characteristically, the third and fourth degree of osteoarthritis can completely deprive a person of the ability to walk due to fusion of the joint surfaces (ankylosis).
Which joint is most often affected?
According to medical statistics, the lower extremities are the most susceptible to osteoarthritis. The joints suffer from inflammation and degeneration: hip, knee.
In case of problems in the hip joint, the pain in the pelvis is initially felt after a long walk or run. With the active progression of the pathology, pain intensifies and mobility is limited.
A person will notice an unpleasant stiffness in the joint, and in certain positions the stiffness increases several times at a time. In the later stages of osteoarthritis of the hip joint, the patient unconsciously protects the affected leg and tries not to step on it at all. It does not move the pelvis, which helps relieve pain.
Osteoarthritis of the knee joint is manifested by discomfort and painful pain after walking. There are no external manifestations of the problem and inflammation. The most common prerequisite for osteoarthritis of the knee joint is its past trauma in the context of damage to internal structures.
Such injuries, as a rule, cause abnormalities in the contiguous joint surfaces in contact. It also takes place:
- overloading certain areas of the cartilage;
- its rapid wear.
The changes, as in the previous case, depend on the degree of osteoarthritis. You should also take into account the causes of the disease, the availability of appropriate medical care, the general condition of the body and the dynamics of the pathological process. Some forms of the disease do not last long and do not progress.
Sometimes, even for decades, there is no obvious deterioration in the knee. In other cases, there is a rapid increase in symptoms and a high probability of loss of mobility.
Get rid of osteoarthritis
Today, there are 2 main directions in the treatment of osteoarthritis of the large joints: medical and surgical.
First of all, the treatment is aimed at rapidly improving blood circulation in the diseased joint and accelerating the properties of cartilage tissue with the help of drugs. Anesthesia and removal of inflammation are also required. For these purposes, doctors practice the use of the following drugs.
Non-steroidal anti-inflammatory drugs (NSAIDs)
These drugs interfere with the natural chemical chain in cartilage that causes inflammation. There is swelling in the tissues, pain appears, and the strength of the cartilage decreases during movement.
Thanks to the use of anti-inflammatory drugs, it is possible to reduce or completely stop the pain syndrome. The start of the so-called inflammatory chain process is also prevented, which helps to accelerate the regeneration of the affected areas.
The drugs are produced in the form of tablets, powder, and rectal suppositories. Treatment tactics, the choice of a specific drug is determined by the doctor strictly individually, depending on the clinical picture of the disease, its dynamics and concomitant pathologies.
Opioids and chondroprotectors
Strong centrally acting pain relievers are called opioids. These drugs generally have a narcotic effect on the body, increasing pain sensitivity thresholds. Thanks to this treatment, pain in the affected joints can be reduced.
The use of drugs in this group should be strictly under the supervision of the attending physician, since such drugs cause mental and physical dependence.
To accelerate the restoration of cartilage tissue, special means are used - chondroprotectors. In general, they are the structural elements of the cartilage itself, which allows them to have an activating effect on its recovery.
These medications include:
- Chondroitin Sulfate;
- Glucosamine sulfate;
- hyaluronic acid.
Chondroitin and glucosamine are organic substances that are abundant in the intercellular space of cartilage. The mechanism of its action on the joints has not yet been fully understood, however, it has been repeatedly shown to have a positive effect on the regeneration of cartilage tissue during treatment.
Chondroitin-based drugs activate the production of special substances from the extracellular matrix of cartilage (proteoglycans and hyaluronic acid). At the same time, the reabsorption process in the tissues is significantly inhibited. In the same way, certain chemical processes are suppressed, there is a decrease in inflammation in the cartilage, damage and the severity of the pain syndrome.
Long-term use of drugs is often required in this group. A course of treatment is required for at least 6 months. Otherwise, the benefits of therapy should not be expected. The organic combination of chondroitin and glucosamine is practiced more frequently. However, clinical studies have not confirmed a significant difference between such treatment and the use of only one of the chondroprotectants.
Despite the obvious benefits and safety, not everyone can treat osteoarthritis of the joints with such drugs due to the relatively high cost.
Hyaluronic acid is no less common in modern medicine. It is a long chain of carbohydrates that provide elasticity and viscosity to the synovial fluid. The unique properties of hyaluron are largely responsible for the good gliding properties of joint fluid.
Intra-articular injections of the drug have a good effect on the state of the body, because studies have shown that osteoarthritis is often triggered by a decrease in the concentration of hyaluron within the joint and a shortening of the chain of its molecules.